COMPARISON OF EFFECTIVENESS AND CHANGE OF SAGITTAL SPINOPELVIC PARAMETERS BETWEEN MINIMALLY INVASIVE TRANSFORAMINAL AND CONVENTIONAL OPEN POSTERIOR LUMBAR INTERBODY FUSIONS IN TREATMENT OF LOW-DEGREE ISTHMIC LUMBAR SPONDYLOLISTHESIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 SUNXin , ZENGRong , LIGuangsheng , WEIBo , HUZibing , LINHao , CHENGuanghua , CHENSiyuan , SUNJiecong

Department of Orthopaedics, Guangdong Medical College Affiliated Hospital, Zhanjiang Guangdong, 524001, P. R. China;

Corresponding author：

SUNXin, Email: sunxin20088@126.com

Keywords：

Isthmic lumbar spondylolisthesis; Lumbar interbody fusion; Sagittal spino-pelvic parameter; Minimally invasive surgery; Open surgery

DOI：

10.7507/1002-1892.20150322

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Objective To compare the effectiveness and changes of sagittal spino-pelvic parameters between minimally invasive transforaminal lumbar interbody fusion and conventional open posterior lumbar interbody fusion in treatment of the low-degree isthmic lumbar spondylolisthesis. Methods Between May 2012 and May 2013, 86 patients with single segmental isthmic lumbar spondylolisthesis (Meyerding degree Ⅰ or Ⅱ) were treated by minimally invasive transforaminal lumbar interbody fusion (minimally invasive group) in 39 cases, and by open posterior lumbar interbody fusion in 47 cases (open group). There was no significant difference in gender, age, disease duration, degree of lumbar spondylolisthesis, preoperative visual analogue scale (VAS) score, and Oswestry disability index (ODI) between 2 groups (P>0.05). The following sagittal spino-pelvic parameters were compared between 2 groups before and after operation: the percentage of slipping (PS), intervertebral height, angle of slip (AS), thoracolumbar junction (TLJ), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), spino-sacral angle (SSA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). Pearson correlation analysis of the changes between pre- and post-operation was done. Results Primary healing of incision was obtained in all patients of 2 groups. The postoperative hospital stay of minimally invasive group [(5.1±1.6) days] was significantly shorter than that of open group [(7.2±2.1) days] (t=2.593, P=0.017). The patients were followed up 11-20 months (mean, 15 months). The reduction rate was 68.53%±20.52% in minimally invasive group, and was 64.21%±30.21% in open group, showing no significant difference (t=0.725, P=0.093). The back and leg pain VAS scores, and ODI at 3 months after operation were significantly reduced when compared with preoperative ones (P<0.05), but no significant difference was found between 2 groups (P>0.05). The postoperative other sagittal spino-pelvic parameters were significantly improved (P<0.05) except PI (P>0.05), but there was no significant difference between 2 groups (P>0.05). The correlation analysis showed that ODI value was related to the SVA, SSA, PT, and LL (P<0.05). Conclusion Both minimally invasive transforaminal lumbar interbody fusion and conventional open posterior lumbar interbody fusion can significantly improve the sagittal spino-pelvic parameters in the treatment of low-degree isthmic lumbar spondylolisthesis. The reconstruction of SVA, SSA, PT, and LL are related to the quality of life.

Citation： SUNXin, ZENGRong, LIGuangsheng, WEIBo, HUZibing, LINHao, CHENGuanghua, CHENSiyuan, SUNJiecong. COMPARISON OF EFFECTIVENESS AND CHANGE OF SAGITTAL SPINOPELVIC PARAMETERS BETWEEN MINIMALLY INVASIVE TRANSFORAMINAL AND CONVENTIONAL OPEN POSTERIOR LUMBAR INTERBODY FUSIONS IN TREATMENT OF LOW-DEGREE ISTHMIC LUMBAR SPONDYLOLISTHESIS. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(12): 1504-1509. doi: 10.7507/1002-1892.20150322 Copy

1.	Mac-Thiong JM, Berthonnaud E, Dimar JN 2nd, et al. Sagittal alignment of the spine and pelvis during growth. Spine (Phila Pa 1976), 2004, 29(15):1642-1647.
2.	Chaléat-Valayer E, Mac-Thiong JM, Paquet J, et al. Sagittal spinopelvic alignment in chronic low back pain. Eur Spine J, 2011, 20 Suppl 5:634-640.
3.	Ohtonari T, Nishihara N, Suwa K, et al. Dynamic stabilization for degenerative spondylolisthesis and lumbar spinal instability. Neurol Med Chir (Tokyo), 2014, 54(9):698-706.
4.	隋海涛, 李亮, 马晓春, 等. 腰椎峡部裂滑脱患者脊柱-骨盆矢状位的平衡. 临床骨科杂志, 2015, 18(2):136-138.
5.	徐宝山, 马信龙. 脊柱骨盆矢状力线在脊柱疾患中的意义. 中华骨科杂志, 2012, 32(1):80-85.
6.	马泓, 吕国华. 腰椎滑脱患者脊柱-骨盆参数改变的研究进展. 中国脊柱脊髓杂志, 2014, 24(3):271-274.
7.	苏锴, 郭营, 汤嘉军, 等. 微创经椎间孔腰椎体间融合术与传统开放手术对退变性腰椎滑脱症腰椎-骨盆矢状位参数的不同影响. 中国脊柱脊髓杂志, 2014, 24(3):204-210.
8.	苏锴. 微创经椎间孔腰椎椎体间融合术与传统开放手术对退变性腰椎滑脱症腰椎-骨盆矢状位参数的不同影响. 广州:南方医科大学, 2014.
9.	李亮, 姜保恩, 马晓春, 等. 矢状面平衡参数在低度峡部裂腰椎滑脱患者脊柱-骨盆矢状位平衡中的意义. 颈腰痛杂志, 2014, 35(2):96-100.
10.	戴胡明, 方诗元, 夏睿, 等. 传统入路与椎旁肌间隙入路置入椎弓根螺钉治疗胸腰段骨折. 中国组织工程研究, 2013, 17(13):2339-2345.
11.	陈涛, 贾世青, 陈武, 等. 椎体间融合内固定治疗腰椎滑脱症:脊柱-骨盆参数的变化. 中国组织工程研究, 2013, 17(4):576-581.
12.	Glassman S, Berven S, Bridwell K, et al. Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa1976), 2005, 30(6):682-688.
13.	任杭岭, 耿伟, 马金柱等. 腰椎滑脱症患者手术前后脊柱-骨盆矢状位参数变化与临床疗效的相关性分析. 中国修复重建外科杂志, 2015, 29(10):1269-1274.
14.	胡日鹤, 胡田生, 周初松, 等. 不同融合术式联合椎弓根复位内固定系统治疗峡部裂性腰椎滑脱症247例临床观察. 现代医院, 2012, 12(2):28-31.
15.	田社聚. 治疗峡部裂性腰椎滑脱症32例的疗效观察. 河南外科学杂志, 2013, 19(4):40-41.
16.	李亮, 隋海涛, 于学忠, 等. 轻度峡部裂性腰椎滑脱症融合前后脊柱-骨盆矢状位参数及临床疗效分析. 中国修复重建外科杂志, 2013, 27(11):1338-1344.

1. Mac-Thiong JM, Berthonnaud E, Dimar JN 2nd, et al. Sagittal alignment of the spine and pelvis during growth. Spine (Phila Pa 1976), 2004, 29(15):1642-1647.
2. Chaléat-Valayer E, Mac-Thiong JM, Paquet J, et al. Sagittal spinopelvic alignment in chronic low back pain. Eur Spine J, 2011, 20 Suppl 5:634-640.
3. Ohtonari T, Nishihara N, Suwa K, et al. Dynamic stabilization for degenerative spondylolisthesis and lumbar spinal instability. Neurol Med Chir (Tokyo), 2014, 54(9):698-706.
4. 隋海涛, 李亮, 马晓春, 等. 腰椎峡部裂滑脱患者脊柱-骨盆矢状位的平衡. 临床骨科杂志, 2015, 18(2):136-138.
5. 徐宝山, 马信龙. 脊柱骨盆矢状力线在脊柱疾患中的意义. 中华骨科杂志, 2012, 32(1):80-85.
6. 马泓, 吕国华. 腰椎滑脱患者脊柱-骨盆参数改变的研究进展. 中国脊柱脊髓杂志, 2014, 24(3):271-274.
7. 苏锴, 郭营, 汤嘉军, 等. 微创经椎间孔腰椎体间融合术与传统开放手术对退变性腰椎滑脱症腰椎-骨盆矢状位参数的不同影响. 中国脊柱脊髓杂志, 2014, 24(3):204-210.
8. 苏锴. 微创经椎间孔腰椎椎体间融合术与传统开放手术对退变性腰椎滑脱症腰椎-骨盆矢状位参数的不同影响. 广州:南方医科大学, 2014.
9. 李亮, 姜保恩, 马晓春, 等. 矢状面平衡参数在低度峡部裂腰椎滑脱患者脊柱-骨盆矢状位平衡中的意义. 颈腰痛杂志, 2014, 35(2):96-100.
10. 戴胡明, 方诗元, 夏睿, 等. 传统入路与椎旁肌间隙入路置入椎弓根螺钉治疗胸腰段骨折. 中国组织工程研究, 2013, 17(13):2339-2345.
11. 陈涛, 贾世青, 陈武, 等. 椎体间融合内固定治疗腰椎滑脱症:脊柱-骨盆参数的变化. 中国组织工程研究, 2013, 17(4):576-581.
12. Glassman S, Berven S, Bridwell K, et al. Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa1976), 2005, 30(6):682-688.
13. 任杭岭, 耿伟, 马金柱等. 腰椎滑脱症患者手术前后脊柱-骨盆矢状位参数变化与临床疗效的相关性分析. 中国修复重建外科杂志, 2015, 29(10):1269-1274.
14. 胡日鹤, 胡田生, 周初松, 等. 不同融合术式联合椎弓根复位内固定系统治疗峡部裂性腰椎滑脱症247例临床观察. 现代医院, 2012, 12(2):28-31.
15. 田社聚. 治疗峡部裂性腰椎滑脱症32例的疗效观察. 河南外科学杂志, 2013, 19(4):40-41.
16. 李亮, 隋海涛, 于学忠, 等. 轻度峡部裂性腰椎滑脱症融合前后脊柱-骨盆矢状位参数及临床疗效分析. 中国修复重建外科杂志, 2013, 27(11):1338-1344.

Chinese Journal of Reparative and Reconstructive Surgery

COMPARISON OF EFFECTIVENESS AND CHANGE OF SAGITTAL SPINOPELVIC PARAMETERS BETWEEN MINIMALLY INVASIVE TRANSFORAMINAL AND CONVENTIONAL OPEN POSTERIOR LUMBAR INTERBODY FUSIONS IN TREATMENT OF LOW-DEGREE ISTHMIC LUMBAR SPONDYLOLISTHESIS

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